Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mauricio Antezana

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063876399

Mauricio Antezana is a Student in an Organized Health Care Education/Training Program in Atlantis, Florida. Practices as a sole proprietor and works from 2 locations. Licensed in Florida and New York.

Licensed in
FL, NY
In the registry since
2016
Specialties on file
2

Practice location Address checks out

115 John F Kennedy Dr
Atlantis, FL 33462-1152
Phone: (561) 967-3513
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 111 E 210th St, Bronx, NY 10467-2401 — (718) 920-4321

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DN22246 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NY)

Record details

NPI number1063876399
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 12, 2016
Last updated in NPPESJuly 21, 2022

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